I'm a newbie. Can somebody tell me a rough idea how how much I should set aside if I have a 20% co-pay? I don't have the foggiest idea what I'm facing here.

Teamshrink

It depends on your health plan. Mine charges a co-pay for doctor visits and prescription medications but not for the treatment itself, or for hospitalization.

In my case, IMRT was $5,000 per treatment (each day!) and there was a one time $20,000 programming fee. There was no copay for this. There was no copay for chemo which was very expensive as well. There was no co-pay for scans and lab work but that changed last year. They now charge a flat fee of $50 for any scans except chest x-rays which are $10 and $10.00 for any lab work.

Typically most insurance policies have a copay limit where there is an annual maximum, then your copay goes away for the remainder of that year.

Some plans also have a 1/2 million dollar limit.

Check with your plan administrator where you work.

The explanation of benefits from my insurance company show about $10,000 for the initial simulation, and $950 per daily treatment. Payment to the provider was about 80% of that.

I also had IMRT, so I don't know the difference between the HUGE disaprity with Gary's cost of treatment. Unless the cost has come down since 2003.

Gary,

I was stunned when I read some of the figures in your post. I remember sitting down with a big stack of medical invoices after I was finished with all my treatment and adding them up to try to determine the total cost. What I came up with (17 years ago) was a total of around $30,000 for: a) multiple scans and other tests to arrive at the treatment plan, b) partial glossectomy and right side neck dissection, c) radiation simulation plus 34 daily XRT treatments, d) radiation implant (surgical procedure) followed by a hospital stay, which I was told equated to an additional 5 daily treatments.

I guess this just proves what has happened to medical costs in the past couple of decades.

Cathy

My husband finished 33 IMRT treatments Memorial weekend. His sessions were $2300 per day, occasionally up to $3500 (maybe those were the days they also did xrays and RO check ups)
The planning session was $12,000. We were lucky all we had to pay was one $30 copay.
Maybe part of the disparity in costs is also regional?

The institutions (particularly public) charge whatever they can get. I will be happy to scan and send copies of my "courtesy" bills from UCSF if anyone wishes or doubts -email me privately. I was told, informally that my HMO didn't pay anywhere near that amount because they have a "deal" with the CCC. It might indeed have been closer to RileyMC's numbers. Most costs of everything are based on some degree on the region where you live. San Francisco is one of the most expensive places to live in North America. There was an article in this mornings paper of what a million dollar house is in the SF Bay Area today. This can range from a 1920's, 2,026 sq ft house in Oakland to a 1,510 sq ft 1955 tract house in San Mateo (what used to be considered "middle class" residences). In Portland 1 million will buy you a brand new 3,533 ft home with 3 br, 3 bath, in Houston it will buy you a 2005, 6,413 sq ft house w/5 bedrooms and 4.5 baths, in Madison WI, a 1997 5,287 sq ft with 4 br and 2.5 baths. Manhattan has us beat 1 million will buy you a 2006, 1 bedroom, 2 bath, 1,021 sq ft.

You could buy a bunch of houses in Cherokee Village for a million $, either on one of our 7 lakes or 2 golf courses. Amy

Hi Teamshrink,
We've ended up with thousands of dollars of copays since Jack was diagnosed in January. Insurance policies vary widely and you need to call member services to find out what the specifics of yours is. Since you have a 20% copay I'd also call the billing office of the radiation center and ask them for an estimate of your bill. Tell them why, they should be used to this. I've also set up long term monthly payment plans for a few of these big bills. Cancer is not cheap. Good luck.
Regards JoAnne

Hi Teamshrink -

JoAnne got it right -- Cancer is not cheap. Right after Kenny was diagnosised, I called our insurance customers service department and they were super! They reviewed all the ins & outs of Cancer treatment billing and confirmed the docs were in the network, etc. My last tally for all of Kenny's 2005 treatments (both radiation & chemo), tests, scans, follow-ups, etc. was around $108,000. We quickly hit the annual out of pocket cap, so most of this was adjusted by the provider or paid by the insurance company. We met the out of pocket cap early again this year. Most of his perscriptions were generic - so they fell into the lowest amount per Rx ($10 each for us).

At your first appointments, meet with the business office manager and make payment arrangements up front. You do not want to have nasty letters or calls coming in while you are in the middle of this battle. Easier delt with head on.

Hang in there -
Carol